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Birthing the Placenta: Midwifery Care for the Immediate Postpartum


Image of a woman, her baby, and the placenta after birth for a blog post about birthing the placenta.

You finally have your hard-earned brand new baby in your arms, the sweat has not even dried from your brow, but you feel a new surge building in your deflating abdomen. Wait, this hurts still! You thought you were done, what gives!? Much to your disappointment you remember there is one more big work of labor left to do- the birth of the placenta. In light of the prize you earn from birthing your baby, birthing the placenta doesn't seem nearly as exciting or gratifying- but it's a very important aspect of the birth process.


As homebirth midwives, we have a unique understanding of the physiological nature of this stage in labor and how we can support a natural process not just through birth but into postpartum. The art of a physiological postpartum is getting completely lost in favor for an over-medicalized standard. Come with us as we discuss the benefits of the midwifery model applied to placenta birth and why it is something we must work to preserve!


Here's the line-up of what's been packed into this helpful post:

  1. What Actually Happens After the Birth- Blood Loss and Pushing Again

  2. Holy Hormones- Oxytocin vs. Pitocin

  3. Complications of the Immediate Postpartum- Hemorrhage and Other Concerns

  4. Medical Management of Placenta Birth

  5. Midwifery Management of Placenta Birth

  6. Optimal Cord Closure- When to Cut and Handling Newborn Emergencies

  7. Utilizing the Placenta- Encapsulate or Not?

  8. Iron Building Protocol (Instant Download)



What Actually Happens After the Birth

The immediate postpartum time can feel like quite a whirlwind. Moms are usually so distracted with the relief that labor is over, and overjoyed to finally have their baby in their arms. As midwives, we aim to bring as much mindfulness into the events after the birth as before, because we see some very important sequences of bonding and recovery happening. It is also a time of alertness for the care provider, as the risk for bleeding complications is at it highest during this stage.


There are 3 stages of childbirth. Stage 1 includes all the labor leading up to pushing the baby out. Stage 2 includes the beginning of pushing the baby out, through the birth of the baby. Stage 3 begins just after the baby has been born, and ends once the placenta has been birthed. Wanting to continue a non-interventive third stage after a non-interventive first and second stage is a reasonable desire! Don't buy into the narrative that a low-risk and natural birth suddenly requires a medically managed postpartum. Your body will not suddenly fail once the baby has been born.


If you want help creating a Birth Vision, a template for articulating how and why your desires matter, click HERE to grab a free instant download of your very own worksheet.


Blood Loss

Your body is incredibly wise and capable when it comes to preparing for birth. By 28 weeks your blood volume has expanded to increase by 50%! Blood loss is a normal part of birth and postpartum. You may experience bloody show in labor as your cervix softens and dilates. You may notice a flash of bright bleeding from a vaginal or labia tear during the birth of your baby. All women have some type of postpartum bleeding, ranging from larger gushes with the delivery of the placenta to a flow like a heavy period in the days following the birth.


Postpartum hemorrhage is the greatest clinical concern during the third stage, which is why we are addressing it right away in this post! Although our preference is for hands-off care postpartum, it is always appropriate to remain watchful and discuss risk factors with each woman before and during the process. Postpartum hemorrhage remains the leading cause of death for birthing women, worldwide- contributing to about 25% of documented maternal morbidity (or medical problems). Women who are at a higher risk for hemorrhage include:

  • Induced or augmented labor, especially with a uterine stimulant like Pitocin

  • Laboring with an epidural

  • Gestational disease like hypertension or preeclampsia

  • Placenta attachment abnormalities (accreta, previa)

  • Multiple pregnancy (twins or more)

  • Infection

  • Anemic or poor blood volume expansion in pregnancy

  • History of severe postpartum hemorrhage

  • Prolonged labor

  • Five or more previous births

You'll note from the list above that all but the last 4 items are contraindicated for homebirth with midwives. Homebirth clients are already in a very low low risk category by default, but remember, 90% + of pregnant women are going to be considered low risk enough to be homebirth candidates- be encouraged that a vast majority of women are not at an increased risk for hemorrhage. Women who have had a low-interventive labor and birth are at the lowest risk for complications postpartum in all birth settings; so the most protective thing you can do for a safe postpartum is plan for the most physiological birth.


If your curiosity is piqued about homebirth candidacy, hop over to THIS post, Is Homebirth Right for You?


Pushing Again

Once your baby has been born, it can take as little as 5 minutes or up to 2 hours for a natural birth of the placenta to take place. Although most placentas come on their own closer to 30 minutes after the birth, it can be perfectly normal for it to take some time, especially when a physiological phase is understood and respected.


In our practice, we understand and make space for labor timelines to include a huge range of normal, from 3 hours (or less!) to 3 days (or more!). We do the same with the pushing phase- it can take minutes or hours and still be considered normal. We'll argue that it's appropriate to look more critically at a flexible range for placenta delivery times as well. Women are not machines, and many factors go into individual placenta delivery times. Here are a couple to note:

  • The spacing and strength of contractions (it will take longer when contractions are further apart or weak)

  • The biological hormonal cascade on board (interruptions to this can delay placenta birth)

  • Distractions in the birthing space (too much talking, bright lights or activity)

  • The location of placenta attachment inside the uterus (lower-lying placement will take longer to detach as the uterus contracts from the top down during postpartum)

  • Complications with the birth or baby (maternal stress or newborn resuscitation)

While it is true evidence-wise that the longer the placenta delivery takes, the higher the rate of placenta complications- it doesn't necessarily mean that artificially facilitating the delivery of the placenta reduces risk. (We'll talk about that more below.)


Let's walk through the mechanism of the third stage:

  1. Your baby is born, the hormones cascade, and your uterus notices the void your baby left and begins to contract down in size.

  2. Each contraction comes down tighter and tighter around what is left in your uterus, the placenta, until it squeezes at the attachment site and the placenta lifts off the uterine wall and peels away. A small gush of blood is usually noted at the vagina when this happens- we call it the separation gush.

  3. The uterus continues contracting, squeezing the open capillaries of the placenta site closed and pushing the newly freed placenta down through the cervix. We can often see the cord lengthening on the outside as the placenta moves down.

  4. The weight of the placenta sitting at the uterine opening often stimulates a sensation for the mother to bear down again, moving the placenta through and out of the vagina. Once the placenta is in the vagina, it usually comes out in one big push.



Holy Hormones- Oxytocin vs. Pitocin


Oxytocin: The True Hero

There is an important and necessary hormonal build up to the birth of the placenta. The very same biological system we have trusted to unfold well on its own during labor, can certainly be trusted to continue unfolding to purposefully and expertly birth the placenta.


Oxytocin, known as the love hormone, takes the center stage postpartum, but it doesn't start there. Pregnancy prepares you for peak sensitivity to hormone receptivity. Oxytocin is already 3-4 times more concentrated in blood levels during pregnancy and continually increases during labor, contributing to stronger and more powerful contractions. It is made in the hypothalamus and releases into the blood by the pituitary gland. Oxytocin also assists in the mobilization of endorphins during active labor, helping to reduce pain, anxiety, and stress for the birthing woman. Your brain actually wants you to enjoy birth!


Oxytocin causes the uterus to contract all throughout labor and postpartum- surging the cervix open, assisting with expulsion of the baby, and sheering off the placenta from the uterus before finally expelling the placenta. Oxytocin peeks to record levels just as the baby is emerging and is the cause of some women's experience of euphoria after the birth. A huge surge of dopamine releases at the time of an undisturbed birth, and is responsible for a sense of pleasure and well-being for the woman for up to an hour postpartum.


Birth is biologically set up to be rewarding and motivating for the mother so she will form protective and care-taking attachment to her baby, ensuring it's survival. Likewise, the hormones released in labor are carried to the baby and prepare him for the transition of breathing air. (This is why babies born by pre-labor cesarean are several times more likely to experience breathing difficulties.) This wonder hormone is also naturally stimulated during skin to skin and breastfeeding, which helps to clamp down the little blood vessels where the placenta detaches, controlling bleeding and involuting (making smaller) the uterus during the postpartum time.


Pitocin: The Hormone Marauder

Pitocin is the synthetic, manufactured form of oxytocin and a household name in the labor and delivery world. Although oxytocin and Pitocin are molecularly identical, they behave differently in the body. Pitocin does not cross the blood brain barrier and has no effect on the neurological or psychological experience of the birthing mom.


Pitocin is administered by IV or muscular injection, travels through the blood to cell receptors on the the uterus and has the single-serving action of causing the uterus to contract. Because of the artificial use and uptake of this synthetic hormone, higher doses of Pitocin often cause greater experiences of pain as the cell receptors become desensitized to the steady "overdose", which requires more and more of the drug to remain effective. Pitocin also inhibits the natural production of oxytocin in the brain, sometimes well into the first week after the birth- interrupting optimal breastfeeding initiation.


It is clear, from a physiological perspective, that we want to do everything we can to promote and support healthy oxytocin production. Avoiding Pitocin is one way to protect a normal hormone cascade in labor and postpartum, as well as maintaining an environment where the mother feels safe and supported.


Stress hormones, catecholamines, are well-studied intrusions to natural oxytocin production. They alert your sympathetic nervous system to any danger present- halting the birth of a baby or placenta. We would even venture to say that this type of stress is a risk factor for birth complications, simply because of the way it interrupts normal hormonal patterns designed to keep birth safe. This aspect of perceived safety is an important explanation for the woman's inherent need to feel confident and comfortable with the support of their birthing location and care provider. They are considered the gatekeepers of the normal hormone experience.


Because Pitocin often inhibits natural hormone production, the good types of stress hormone can also be interrupted to the deficit of the birth experience. The intensity of a natural labor releases healthy amounts of cortisol that help moms take in their new baby with alertness and a second wind of energy. Women who receive Pitocin in labor are more likely to have an interventive postpartum, including needing more Pitocin for the delivery of the placenta and experiencing blood loss that requires pharmaceutical treatment.



Complications of the Immediate Postpartum

We mentioned earlier that right after the birth is when care providers need to be alert and watchful. Midwives expect postpartum to continue to unfold well on it's own, but we are there for the situations that require our expertise so we can step in with the most minimal intervention that will bring things back into normal again. Hemorrhage is by far the most common complication to come up postpartum. We actually include it in our top 3 most common complications to happen at any point during birth, read about it all HERE. Hemorrhage is actually the outcome of another complication that puts blood loss in motion.


Hemorrhage

Hemorrhage is distinguished from other types of normal heavy bleeding by volume of blood loss and the symptoms of the mother in relation to the blood loss.

  • Hemorrhage is diagnosable at 1000 ml of blood loss or more, either by measurement or estimation. Some birthing facilities capture all the fluids at birth with a large collection bag at the end of the patient's bed where blood flows in and is measurable. Midwives typically capture fluids onto soft, absorbable chux pads (or practice observing the color change in birth tubs). We are skilled at estimating the volume based off of heaviness and saturation of the pad. Some care providers even weigh the pads to check their estimations.

  • Hemorrhage is also diagnosable with signs and symptoms of low blood volume, regardless of blood loss measured/estimated. Some of these include dizziness, paleness of skin, low blood pressure, quickened pulse, visual disturbances, nausea, sweating, weakness and fainting.

Some women can experience symptoms of low blood volume and lose far less than 1000 ml of blood, while others can lose 1000 ml or more and have no difficulty integrating their postpartum recovery. Most women who lose 1000 ml of blood are going to have accompanying symptoms, and any woman with symptoms, no matter the blood loss, should be assessed carefully and will likely be offered treatment.


The first step in treating hemorrhage is discovering where the blood loss is coming from. There are 4 main causes of bleeding postpartum, and 4 different courses of treatment dependent of the cause:

  1. Tone: a lack of tone (atony) in the uterus making it weak and soft. Atony accounts for over 80% of hemorrhages. This type of bleeding can occur right away with a partially detached placenta, and continue for many hours postpartum with a very tired uterus. A fundal check is the diagnosing maneuver, where the provider feels the top of the uterus to assess firmness. A uterus with good tone will feel hard and be found near the belly button of the mother. A uterus with poor tone with be soft and squishy and undistinguishable from the other contents of the abdomen. This type of bleeding is usually dark red and comes in gushes. Rubbing the top of the atonic uterus should bring it to firmness under the provider's hand- although fundal massage while the placenta is still inside can cause excess bleeding. Treatment for atony include expediting placenta delivery, uterine massage, herbal hemostatic tinctures, emptying the bladder, and uterotonic medications (Pitocin, etc).

  2. Trauma: damage to the uterus, cervix, vaginal tissue, labia, or perineum. Trauma can be caused by surgical birth, instruments used during delivery, or tissue tearing under pressure at the time of birth. This type of hemorrhage is characterized by sudden bright red bleeding and is diagnosed by observing the injury where the blood is flowing from. Trauma-related hemorrhage must be repaired surgically by placing sutures into the tissue to occlude (repair and close up) the bleeding vessels.

  3. Tissue: retained placenta tissue in the uterus, sometimes amniotic membrane but usually a part (or all) of the placental bed. This is most common with assisted delivery of the placenta, expediting the birth of it before all sections are detached from the wall of the uterus, or placenta implantation abnormalities. The uterus knows it needs to be empty to clamp down effectively and bleeds to try to flush itself of any remaining parts. The delivered placenta can be quickly inspected for completion or missing lobes. If retained tissue is suspected the uterus will need to be manually swept (with a sterile gloved hand) and removed. Often uterotonic medications are given to assist in contracting the uterus to treat and prevent further bleeding. In the case of tissue firmly implanted, surgical removal is necessary.

  4. Thrombin: a blood clotting disorder that makes blood loss from any of the above causes severe, although very rare. A coagulation disorder or maternal disease like preeclampsia can make a tiny bleed uncontrollable. This type of bleeding will not respond well to conventional treatment and may require interventions like ongoing medications, blood volume replacement or surgical methods for controlling bleeding.

Once bleeding is under control, or while it is being controlled, replacing the blood volume lost is the next clinical step. The care provider may offer IV fluids or discuss options for a blood transfusion. Midwives carry and administer fluids at home, but would need to transfer to a hospital for blood products to be given. Not every hemorrhage is going to require blood volume replacement, but good rest for many days or weeks after the birth is absolutely imperative for a full recovery. A lab test, like a complete blood count, can be done to monitor the hemoglobin (oxygen carrying capacity of the blood cell) as the mother recovers, and guide the provider on how to continue supporting blood volume recovery.


Other Concerns

Placenta Accreta

Placenta implantation issues, like placenta accreta- are often diagnosed in pregnancy during the anatomy scan- but can be missed and not suspected until after the birth when the placenta simply is not being born as expected. Although rare, the placenta can become so abnormally and deeply implanted into parts of the uterus that it does not detach well on its own. This complication is often marked with heavy bleeding, but can certainly present without excessive blood loss if the entire placenta is remaining attached. The homebirth client would transfer in any case where the placenta was presenting with exceptional difficulty in being born. Often these cases require quite a bit of medical or surgical management to complete the third stage.


Uterine Inversion

Uterine inversion is another rare complication that can require intervention during the third stage of labor. Uterine inversion is when the uterus turns somewhat inside-out and protrudes from the vagina. This is most likely to happen with mismanagement of the placenta delivery- if the cord is given too much traction before the placenta has fully detached and inverts partially (or fully) with placenta delivery. (Yikes, I even had a hard time typing that!) Depending on the degree of inversion, the uterus can be manually replaced into the abdomen, but risk of other complications are high and more medical means of treatment are often necessary.



Medical Management for Birthing the Placenta

We'll share the medical management perspective first before following with midwifery protocols below, because unfortunately, the majority of women are going to experience medical, or active management of third stage.


The basics of active management for placenta delivery include the following:

  1. Administer Pitocin immediately after the birth (usually by IV)

  2. Clamp the cord

  3. Provide cord traction (pulling or steady pressure) until the placenta delivers

The goal of active management is to decrease, or prevent altogether, postpartum hemorrhage. The thought is that controlling the delivery of the placenta gives the provider control of the outcome. Research does in fact support that active management decreases bleeding risk, although the margin is small. Research also shows us that although active management slightly decreases hemorrhage, it slightly increases rates of uterine infection, retained tissue and late postpartum hemorrhage. Postpartum hemorrhage is still the leading cause of maternal death, despite increased practices of active third stage management.


Because the research is mixed, the perceived benefits and risks should be weighed by the birthing parents and proper informed consent given by every provider, in every birth setting. Each woman's individual risk factors should be explored and discussed when the options are given. Unfortunately, in this model, little or no informed consent is given and the preferred method of the provider is typically performed.


Women often report that Pitocin was administered through their IV without permission. IV port placements are usually mandatory interventions given upon admission to an LnD unit, with the explanation that they are needed to create faster responses to treatment in case of hemorrhage. However, IM (intramuscular) injections of Pitocin are just as effective as IV doses, when indicated for excessive bleeding. It's much smoother to discreetly connect a Pitocin drip to an already-placed IV port if practicing active management.


Many birthing families question the active management package: Is it an overall benefit to clamp the cord early, intervene with a forceful delivery and have routine medications given? What might they be missing out on when a physiological process is disturbed? What decisions are being made out of fear or mistrust of that process?



Midwifery Management of Placenta Birth


Remember this graphic from THIS post about Finding A Midwife? It's an important reminder of how midwives do things differently than the medical care model. We believe that birth (and postpartum too!) are designed to work on their own, and work best when left undisturbed. So naturally, we use this as the basis of our management in birthing the placenta- working hard to understand how it is meant to unfold biologically, and ways we can support the natural process.


Midwives who practice an expectant/ physiologic/ hands-off third stage believe that hemorrhage can best be prevented by following the inherently protective unfolding of a natural placenta delivery. (Note: not all midwives practice this way, many have adopted the active management protocols of the medical model.) Midwives intervene to treat an active hemorrhage with medication if one is present, but do not "actively" prevent with uterotonics.


The basics of expectant management for placenta delivery include the following:

  1. Immediate skin-to-skin of newborn with mom

  2. All efforts made to not interrupt mother-baby bonding with unnecessary touching or talking of provider

  3. Watch for positive signs like uterine cramping, a small gush of blood that indicates placenta separation from the uterus, and cord lengthening that indicated the placenta is detached and moving down into the vagina

  4. Encourage mom to respond to cramping and pelvic floor pressure with her own pushing efforts, placenta is delivered spontaneously

  5. Cord clamped and cut after it stops pulsating


Expectant management does not mean neglectful. Midwives remain present, watchful, and aware, intervening when necessary. When there are delays with placenta delivery, midwives continue to rely on and support physiology. Unless there is excessive bleeding, we do not have to jump straight to medications. We can initiate breastfeeding, change mom's position, empty the bladder, and use herbs to support natural delivery.


When excessive bleeding is present, midwives consider the source, cause and rate of blood flow when deciding on an appropriate treatment. If medication is indicated, homebirth midwives in California are licensed to carry and administer 4 different pharmaceuticals, including Pitocin- which is often the first line of action.


When there is a complication, bleeding or otherwise, midwives work to restore and create physiology. If medications are needed, we ask ourselves how we can continue to honor the emotional and familial experience of labor and postpartum.



Optimal Cord Closure

The term "Delay Cord Clamping" has gained a whole lot of popularity recently as women learn and advocate for the benefits of their newborns receiving their own cord blood at the time of birth. The "Delayed" part however can often describe merely 1-3 minutes (or less!) of cord blood delivery- when in fact there is a huge range of time that it can take to *fully* deliver the blood from the placenta. Are you catching on that we are not huge fans of time limits?! Time limits are simply not appropriate for most physiological experiences!


There are no clinical benefits, in a low-risk birth and postpartum, to cutting the cord before the blood stops pulsing through it. (The claim that delayed cutting increases the risk of hyperbilirubinemia and jaundice in newborns has not been proven.) We can look to biology as a baseline for best practices. The cord was not designed to be clamped and cut while it is flowing with blood- there's a needed purpose there that is being interrupted.


Optimal cord closure allows 100 ml of baby's own blood to circulate through the placenta and be permanently delivered to the baby. That's almost 1/2 cup, a huge amount for your tiny baby- adding over 3 ounces to their birth weight. After the birth, the postpartum contractions squeeze the uterus and the placenta pumps blood to the baby through the umbilical cord. This helps the placenta to empty, which is a mechanism of physiological readiness for placenta detachment and birth. There are even more benefits of optimal cord closure:

  • Increased blood volume, resulting in more oxygen circulation and iron reserves

  • Baby better equipped for transition to breathing air

  • Improved circulation of the newborn

  • All stem cells delivered directly, increasing immune and long term health


When to Cut the Cord

Optimal cord closure happens once the umbilical cord has completely stopped pulsating. This can be discovered by feeling the outside of the cord between where it exits the vagina and inserts into the baby's umbilicus. You can actually feel the blood pumping through it between your fingers as it delivers blood from the placenta. Or, by observing the cord as white and limp- it will look plump and blueish purple while delivering blood.


Because we know that an undisturbed birth and postpartum can create a range of normal placenta delivery times, our midwifery care preference is to clamp and cut the cord after the placenta has been delivered. This is usually performed right before the newborn exam, which typically happens 2 or more hours after the baby has been born. One reason for this is that we can be certain the cord has delivered all of the cord blood to the baby- the placenta can only pump blood when it is attached to the uterus. The second bonus of this very delayed/optimal cord cutting is it keeps mom and baby connected and bonding with a real physical tether. This reminds everyone that she is the best place for the baby to be- the cord is only that long for a reason!


What About Newborn Emergencies?

If the baby requires resuscitation, surely we need to cut the cord early and bring the baby to a station for more help, right? NO! In homebirth practice, our resuscitation set-up is mobile, creating a board that comes to baby and allows midwives to work on baby right next to mama. Keeping the cord intact is one of our best tools for helping baby transition well- as all that blood and oxygen from the cord remains a lifeline to a newborn who needs extra care- not to mention the maternal benefits of having baby near and being a part of every event in the life of their baby. Read more about resuscitation of the newborn in THIS post about how midwives handle complications.



Utilizing the Placenta

There are so many options to share for using the placenta after the birth. Discussing this topic is sure to invite some strong feelings, and aversions for placenta use- as well as many misconceptions! We'll share what we know and be certain to provide some clarity. In the end, an informed choice is the right choice!


The placenta serves as a biological bridge between mom and baby during pregnancy. It's responsible for bringing oxygen and nutrients from mom to the baby, while removing waste and filtering toxins. It's a misconception that the placenta itself stores toxins and waste, it actually filters them into the mother's waste and detox system so they can be removed from her body as well. The placenta is full of bioidentical hormones, and rich heme iron.


Some midwives use the placenta immediately after it's birth to treat postpartum hemorrhage- a small chunk of the maternal side under the tongue or inside the cheek is known to slow or stop uterine bleeding. It can also be used in smoothies right after the birth to boost iron and nutrition to the newly recovering postpartum mama. Find our favorite hormone balancing smoothie recipe right HERE.


Placenta Encapsulation

Encapsulation is the most popular way to use the placenta. Although we don't have the clinical evidence to prove ingesting the placenta is beneficial, we have heard from hundreds of women over the years that it makes a positive impact, anecdotally. Placenta ingesting benefits have been reported as:

  • Increase energy and replace iron lost with bleeding

  • Decrease postpartum mood disorders and baby blues

  • Shorten postpartum bleeding time and improve recovery

  • Assist in producing and increasing breastmilk supply


The encapsulation process takes the raw placenta, dehydrates thin strips of it and then grinds it into a loose powder that is placed into empty capsules, making it easy to swallow as a pill. Consuming the placenta this way creates a palatable and shelf-stable way to get the benefits of ingesting it. Most families hire a placenta specialist to perform this service for them, but the process is straight forward enough that with the right equipment and knowledge, self-encapsulation is possible. This method is often recommended as a tapered dose, starting with many capsules a day and weaning off the amount of pills as the weeks go on to stabilize postpartum hormones. The size of the placenta determines the amount of pills rendered, but most women can get 3-4 weeks of daily dosing worth.


Other Placenta Uses

Some other popular uses for the placenta include placenta smoothies, placenta tincture, placenta salve and finally, planting the placenta. Listen to THIS short podcast of ours to hear more about other postpartum rituals you can research and implement.


Smoothies create a way to enjoy the placenta in its raw and natural form. Some moms believe having it raw maintains the highest amount of nutrients. Placenta chunks about the size of a quarter can be cut up and frozen and dropped into a blender with your favorite smoothie ingredients. We offer this placenta prep service to our clients for free and are always happy to report that the placenta can not be tasted! Our best tip is to start with a small amount of liquid (1/2 cup), like citrus or berry juice and make sure the placenta is well-blending into the juice before adding the remaining ingredients. Voila + Bon Apetit! If having 1-2 smoothies a day, this method can often last for 2-3 weeks.


A placenta tincture is a medicine prepared by steeping a small chunk of raw placenta in high grade alcohol for several weeks. The fermentation process breaks down the placenta so each drop can be used as a medicine after 6 weeks. The tincture is shelf stable for years, and can be used homeopathically by replenishing the alcohol each time the tincture liquid is consumed down to 50% in the bottle. This method of placenta use allows the mother to enjoy the (literally never-ending) benefits of the placenta for years to come. Many women use it to support the return of their periods, menopause or even as a teething remedy for their baby. Click HERE for all the many other hormone balancing tips we love to share.


A placenta salve is made by infusing skin nourishing oils with the powder from the placenta dehydration process. This allows the placenta benefits to be used topically, usually with the baby in mind. Salves are great for diaper rash, chapped skin, eczema and other rashes.


For a woman that chooses not to ingest the placenta, or loses the option because the health of the placenta is in question, it doesn't have to go to waste! Many families will burry the placenta in the ground, allowing the nourishing benefits to get into the soil and contribute to the vitality of a special plant or tree. Some families enjoy making a ceremony of this, closing the chapter of pregnancy and birth and welcome postpartum and life with baby. For those that anticipate moving or don't have a yard, a large pot or moveable planter works, too.


No matter how you plan to use your placenta, a supportive postpartum is a priority! You can plan ahead during pregnancy to learn about and fold in the essentials that make postpartum a peaceful and restorative postpartum time. Check out our 9-product-instant-download HERE. Our Postpartum Support + Planning Bundle is a compilation of every topic we encounter in our routine midwifery care, and more! We have included the most helpful worksheets, instructions and recipes to plan ahead and embrace the challenge and joy that life with a newborn brings.



Iron Building Protocol (Instant Download)

One way to be certain that you are building up your blood well, either in preparation for normal blood loss, or in recovery from blood loss postpartum, is to work on getting your iron stores optimal, especially if you have been diagnosed as anemic. Blood building can prove to be quite difficult without some nutritional expertise in your corner. Many iron supplements are poorly made, poorly absorbed and can be both constipating and stomach-upsetting.


The keys to increasing your iron are:

  • locating a quality supplement

  • ingesting the right type of supplemental iron

  • pairing it with the helpers that aid absorption

  • separating it from the nutrients that impede absorption

  • understanding hemoglobin and the functional range you want to see this lab value in during pregnancy and postpartum


Get instant access to our very own Iron Building Protocol used in our midwifery practice HERE.

Inside this resource you'll have ready access to the following:

  1. What anemia is, what causes it, and how it is diagnosed

  2. When to test for anemia and how to read your lab values

  3. Risks to you and your baby's health if anemia is left untreated

  4. How to locate the right supplements and how much to take for best absorption

  5. Troubleshooting guide for stubborn iron levels and GI side effects

  6. When to retest and ideal ranges for pregnancy and postpartum

  7. Direct links to our favorite supplements



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